Brusttrauma

Brusttrauma, or chest trauma, refers to injury to the thoracic cage and its contents resulting from blunt or penetrating forces. This broad category includes injuries to the chest wall, lungs, heart, great vessels, and mediastinal structures. Common mechanisms are blunt trauma from motor vehicle collisions, falls, or sports injuries, and penetrating trauma from stab wounds or gunshots.

Injuries range from simple to life-threatening. Rib fractures, pulmonary contusion, pneumothorax and hemothorax are frequent. More severe problems include tension pneumothorax, flail chest, myocardial contusion, cardiac tamponade, and injuries to the aorta or other great vessels. Sternal fractures may accompany severe thoracic trauma. Associated injuries to other body regions are common and influence outcome.

Assessment and diagnostic workup follow standard trauma protocols. Early airway management, breathing assessment, and circulation stabilization are priorities. Clinical signs include chest pain, dyspnea, tachypnea, reduced breath sounds, subcutaneous emphysema, and chest wall deformity. Imaging typically begins with chest radiography; ultrasound (FAST) helps detect pleural collections and pericardial effusion, while computed tomography (CT) chest is used for stable patients to delineate injuries. Laboratory tests and cardiac monitoring are often indicated.

Management focuses on stabilizing the patient and treating life-threatening conditions. Oxygen therapy and analgesia are foundational. Tension pneumothorax requires immediate decompression; open pneumothorax needs an occlusive dressing; massive hemothorax or unstable injuries may require chest tube thoracostomy or surgical intervention. Cardiac or great vessel injuries may necessitate emergent surgery. Rib fractures are managed with pain control and pulmonary hygiene; severe cases such as flail chest may require ventilation support or surgical stabilization.

Prognosis depends on injury severity and associated trauma. Complications can include pneumonia, empyema, respiratory failure, tamponade, and long-term chest wall deformities.